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Accidents with animals of medical interest in brazil winter school tropical diseases unesp alexandre barbosa 2019

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Accidents with animals of medical interest in brazil winter school tropical diseases

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Accidents with animals of medical interest in brazil winter school tropical diseases unesp alexandre barbosa 2019

  1. 1. Alexandre Naime Barbosa MD, PhD Infectious Diseases Professor Winter School on Tropical Diseases Botucatu School of Medicine - UNESP 2019 - Botucatu - SP - Brazil Accidents with Animals of Medical Interest in Brazil
  2. 2. Content Declaration e Use of This Presentation The following material is part of the educational project produced by Prof. Dr. Alexandre Naime Barbosa Objectives 1. Education: Training for Students & Health Professionals 2. Community: Provide and Translate Scientific Information to the Population; 3. Scientific: Encourage the Scientific Discussion and Share Teaching Materials. Authorship and Assignment 1. Content: The following data are referenced in respect to the original author; 2. Use: It is allowed to use the material, if the source is mentioned; 3. Contact: Talk to Dr. Barbosa and keep in touch with his project in:
  3. 3. Animals of Medical Interest in Brazil 1. The Brazilian Biodiversity 2. Amazon Biome 3. Pantanal Biome 4. Atlantic Forest Biome 5. Marine Biome 6. Conclusions
  4. 4. Animals of Medical Interest in Brazil • Land area: 5th in the World, 3rd in Americas • Climate: from equatorial to temperate • Environment: from rainforests to deserts • Ecosystems: highly diversified • Perfect scenario for a huge biodiversity Wikipedia, 2013
  5. 5. Animals of Medical Interest in Brazil • Brazil: 1st country in biodiversity • Mammals: 689; Fish: over 3,000 • Birds: 1,832; Reptiles: 744 • Invertebrates: over 200,000 • Wildlife distribution: Biomes Brazil Environment Ministry, 2011
  6. 6. Animals of Medical Interest in Brazil • Biomes: six main regions • Amazon: The biggest and most bio-diverse • Pantanal: World's largest wetland area • Atlantic Forest: A biodiversity hotspot • Atlantic Ocean: Marine biodiversity • Others: Caatinga, Savannah and Lowlands Embrapa, 2012
  7. 7. Animals of Medical Interest in Brazil 1. The Brazilian Biodiversity 2. Amazon Biome 3. Pantanal Biome 4. Atlantic Forest Biome 5. Marine Biome 6. Conclusions
  8. 8. Animals of Medical Interest in Brazil • Rainforest in the Amazon River Basin • Equatorial Climate, hot and wet (rain) • Venom: Snakes, Fish, Frogs and Invertebrates • Trauma: Mammals, Reptiles, Fish and Invertebrates WWF, 2014
  9. 9. Animals of Medical Interest in Brazil Some Venomous and Poisonous Animals 1. Snakes: Bothrops sp.; Lachesis sp. 2. Fish: Stingrays, Catfishes 3. Frogs: Dendrobatidae Family 4. Invertebrates: Spiders, Scorpions, Bees, Ants, etc. Haddad Jr et al. JVAT, 2013
  10. 10. Animals of Medical Interest in Brazil Venomous Snake: Bothrops sp. (Jararaca, Jararacuçu, Urutu) - 90% of Snakes Bites; over 60 species - 70 centimeters to 2 meters - Throughout Brazil - Nocturnal, prefers wet places Anacassia Lima, 2012
  11. 11. Animals of Medical Interest in Brazil Venomous Snake: Bothrops sp. (Jararaca, Jararacuçu, Urutu) - Proteolytic, Coagulant and Hemorrhagic - Local edema, pain and necrosis - Coagulopathy, bleeding and renal failure - Fatality rate (Tx): 0,31 %, AV available Anacassia Lima, 2012
  12. 12. Animals of Medical Interest in Brazil Venomous Snake: Lachesis sp. (Surucucu) - 1,5 % of Snakes Bites; 3 species - 2 to 4 meters - Amazon and Atlantic Forest - Prefers dense forests Anacassia Lima, 2012
  13. 13. Animals of Medical Interest in Brazil Venomous Snake: Lachesis sp. (Surucucu) - Proteolytic, Coagulant, Hemorrhagic and Neurotoxic - Coagulopathy, bleeding and vagal hyperactivity - Local edema, pain and necrosis - Fatality rate (Tx): 0,95%, AV available Anacassia Lima, 2012
  14. 14. Animals of Medical Interest in Brazil Venomous Fish: Freshwater Stingrays (Arraia de Água Doce) - Severe pain, local edema and erythema - Cutaneous necrosis and secondary infection - Lytic properties not fully studied - Supportive therapy (hot water) Haddad Jr et al. JVAT, 2013
  15. 15. Animals of Medical Interest in Brazil Poisonous Frog: Dendrobatidae Family (Sapos/Rãs) - Not venomous, but poisonous (skin) - Toxicity through the consumption of small insects - Produce one of the most lethal toxins - Exposure: intentional, in rituals The Sapo Diaries, 2013
  16. 16. Animals of Medical Interest in Brazil Some Trauma Injuries by Animals 1. Mammals: Panthera onca, Tapirus terrestris, Myrmecophaga tridactyla 2. Fish: Vandellia cirrhosa, Electrophorus electricus 3. Reptiles: Eunectes sp., Black Caiman 4. Invertebrates: Blatella germanica Voz do Acre Journal, 2012
  17. 17. Animals of Medical Interest in Brazil Trauma Mammal: Panthera onca (Jaguar, Onça Pintada) - Mainly in the Amazon and Pantanal - Recently new cases in Brazil - Ecotourism and Fishing tourism - “Onça-seeing” tourism Campos Neto et al. WEM 2011
  18. 18. Animals of Medical Interest in Brazil Trauma Mammal: Panthera onca (Jaguar, Onça Pintada) Predatory Attack 1: Non Fatal - Fishermen boat, 17y/o man - cranial-encephalic trauma - brain and bone tissue loss, memory deficit Campos Neto et al. WEM 2011
  19. 19. Animals of Medical Interest in Brazil Trauma Mammal: Panthera onca (Jaguar, Onça Pintada) Predatory Attack 2: Fatal - Fisherman tent, 21y/o man - cervical transection of the spinal cord - cervical and brain tissue and bone loss Campos Neto et al. WEM 2011
  20. 20. Animals of Medical Interest in Brazil Trauma Mammal: Myrmecophaga tridactyla (Anteater or Tamanduá) - Tamanduá: 2 meters, 40 kg - Rare accidents - 47y/o male hunter attacked by defense - Death due to wounds in femural artery Haddad et al. WEM 2014
  21. 21. Animals of Medical Interest in Brazil Trauma Fish: Vandellia cirrhosa (Candiru) - Small parasitic freshwater catfish, 12 cm - Attracted by urine, enter through the urethra - Umbrella-like spines, only removed after surgery - Symptoms: pain and urethra bleeding FUNASA
  22. 22. Animals of Medical Interest in Brazil Trauma Fish: Electrophorus electricus (Poraquê) - Big freshwater knifefish, 2 - 3 meters - Powerful electric shocks of up to 600 volts - Shocks used hunting and self-defense - 4,2% of all aquatic animals accident in a fishermen cohort GarroneNeto et al. CSP 2005
  23. 23. Animals of Medical Interest in Brazil Trauma Reptile: Eunectes sp. (Anaconda, Sucuri) - One of the biggest snakes; 2 to 10 meters - Non venomous - Several reports of attacks to humans - Only accidental attacks The NYC, 2010 Google
  24. 24. Animals of Medical Interest in Brazil Trauma Reptile: Black Caiman (Jacaré-açu) - Not common, accidental - 11y/o girl bathing on a river was attacked - Many wounds and femur fracture - Death due to drowning Haddad Jr et al. WEM, 2011
  25. 25. Animals of Medical Interest in Brazil Ueida et al. IJD 2013 Trauma Invertebrate: Blatella germanica (Cockroach, barata) - Cockroach bites in massive infestation - Poor sanitary conditions, indigenous people - Secondary infections, allergy - Cockroach can enter the ear, nose or mouth
  26. 26. Animals of Medical Interest in Brazil 1. The Brazilian Biodiversity 2. Amazon Biome 3. Pantanal Biome 4. Atlantic Forest Biome 5. Marine Biome 6. Conclusions
  27. 27. Animals of Medical Interest in Brazil • Wetland in the Paraguay River Basin • Tropical Climate, dry or rainy season • Venom: Snakes, Fish and Invertebrates • Trauma: Mammals, Reptiles, Fish and Invertebrates IBAMA, 2013
  28. 28. Animals of Medical Interest in Brazil Some Venomous Animals 1. Snakes: Bothrops sp. 2. Fish: Stingrays, Freshwater Catfish 3. Invertebrates: Spiders, Scorpions, Bees, etc. Haddad Jr et al. RSBMT, 2012
  29. 29. Animals of Medical Interest in Brazil Venomous Fish: Freshwater Catfish P. Maculatus (mandijuba) and P. corruscans (surubim) - Venomous stingers - Pain, inflammation and bleeding - Ulcer can be a complication Haddad Jr et al. RSBMT, 2012
  30. 30. Animals of Medical Interest in Brazil Some Trauma Animals 1. Mammals: Panthera onca, Tapirus terrestris, etc. 2. Fish: Serrasalmus sp. 3. Reptiles: Eunectes sp, Caiman sp. Haddad Jr et al. RSBMT, 2012
  31. 31. Animals of Medical Interest in Brazil Trauma Fish: Serrasalmus sp. (Piranha) - No report of massive attack to humans - Generally 1 single bite per person - Outbreaks related to bathing - Circular wound, laceration of tissues Haddad Jr et al. WEM 2003
  32. 32. Animals of Medical Interest in Brazil Trauma Reptiles: Caiman sp. (Jacaré do Pantanal) - Very rare, accidental - Fisherman 61y/o, only bite on hand - Pain, blending, edema and secondary infection - Trauma and hand fracture Campos Neto et al. DT 2013
  33. 33. Animals of Medical Interest in Brazil 1. The Brazilian Biodiversity 2. Amazon Biome 3. Pantanal Biome 4. Atlantic Forest Biome 5. Marine Biome 6. Conclusions
  34. 34. Animals of Medical Interest in Brazil • Tropical Forest in the Atlantic Coast • Tropical and Subtropical Climate • Venom: Snakes, Fish and Invertebrates • Trauma: Mammals, Fish and Invertebrates IBAMA 2013
  35. 35. Animals of Medical Interest in Brazil Some Venomous Animals 1. Snakes: Bothrops sp.; Crotalus sp.; Micrurus sp 2. Fish: Stingrays, Freshwater Catfish 3. Invertebrates: Spiders, Scorpions, Bees, etc. Butantan Institute
  36. 36. Animals of Medical Interest in Brazil Venomous Snakes: Crotalus sp. (Cascavel) - 7,7 % of Snakes Bites; 32 species (1Br) - 50 centimeters to 1,5 meters - Atlantic Forest, Cerrado, Caatinga - Prefers rocky and dry places Anacassia Lima, 2012
  37. 37. Animals of Medical Interest in Brazil Venomous Snakes: Crotalus sp. (Cascavel) - Coagulant, Miotoxic and Neurotoxic - Bleeding, dark urine and myalgia - Ptosis, myasthenic face and renal failure - Fatality rate (Tx): 1,85%, AV available CEVAP, 2011
  38. 38. Animals of Medical Interest in Brazil Venomous Snakes: Micrurus sp (Coral) - 0,4 % of Snakes Bites; 65 species - 90 centimeters to 1,5 meters - Thoughout Brazil - Reclusive behavior, beneath the ground M. M. Moura, 2012
  39. 39. Animals of Medical Interest in Brazil Venomous Snakes: Micrurus sp (Coral) - Neurotoxic only, but very potent - Acute progressive myasthenic syndrome - Paralysis of respiratory muscles, death - Fatality rate: 0,36%; AV available Anacassia Lima, 2012
  40. 40. Animals of Medical Interest in Brazil Venomous Invertebrates: Spiders Phoneutria sp. (Armadeira) - Agressive, 17 centimeters - Neurotoxic venom, but in low dose - Painful, dangerous to children, AV available Funasa, 2009
  41. 41. Animals of Medical Interest in Brazil Venomous Invertebrates: Spiders Loxosceles sp. (Aranha marrom) - Not agressive, 4 centimeters - Necrotic venom - Without acute symptoms, AV available Funasa, 2009
  42. 42. Animals of Medical Interest in Brazil Venomous Invertebrates: Scorpions Tityus serrulatus (yellow) and T. bahiensis (brown) - Local pain and inflammation - Potential Neurotoxic Venom - Dangerous to children, AV available Funasa, 2009
  43. 43. Animals of Medical Interest in Brazil Venomous Invertebrates: Caterpillar Lonomia sp. - Local pain and inflammation - Hemorrhagic syndrome and Renal Failure - Rare but possible deaths, AV available SMS Curitiba, 2012
  44. 44. Animals of Medical Interest in Brazil Venomous Invertebrates: Bees Apis Mellifera (Africanized honey bees) - 9,000 accidents/y, 26 deaths (2011) - Complex venom, and allergic reaction - No specific antivenom, supportive therapy CEVAP, 2011
  45. 45. Animals of Medical Interest in Brazil Some Trauma Animals 1. Mammals: Tapirus terrestris, Porcupines, etc. 2. Fish: Serrasalmus sp, etc. Google
  46. 46. Animals of Medical Interest in Brazil Trauma Mammals: Tapirus terrestris (Anta) - Tapir: 2 meters, 200 kg - Rare accidents - 55y/o male farmer bitten three times - Death due to bite in the cervical region Haddad Jr et al. WEM, 2005
  47. 47. Animals of Medical Interest in Brazil Trauma Mammals: Porcupines (Ouriços-cacheiros) - Porcupines: small rodent - Rare accidents, non aggressive behavior - 34y/o male tourist tried to capture - After spines removed, the pain stopped Haddad Jr et al. JVAT 2010
  48. 48. Animals of Medical Interest in Brazil 1. The Brazilian Biodiversity 2. Amazon Biome 3. Pantanal Biome 4. Atlantic Forest Biome 5. Marine Biome 6. Conclusions
  49. 49. Animals of Medical Interest in Brazil • Extension: 9.198 km • Climate: from equatorial to temperate • Venom: Fish and Invertebrates • Trauma: Fish and Invertebrates Google
  50. 50. Animals of Medical Interest in Brazil Some Venomous Animals 1. Fish: Stingrays, Marine Catfish and Scorpionfish. 2. Invertebrates: Sponges, Man-of-war, Jellyfish, Octopus and Sea Urchin Google
  51. 51. Animals of Medical Interest in Brazil Venomous Fish: Scorpionfish Scorpaena sp. (Mangangá) - Venomous stings in fin - Strong and long pain - Necrosis can be a complication Brasil Reef
  52. 52. Animals of Medical Interest in Brazil Venomous Invertebrates: Sponges Tedania, Neofibularia and Microciona - Irritating slime and spikes - Allergic symptoms Haddad, 2013
  53. 53. Animals of Medical Interest in Brazil Venomous Invertebrates: Man-of-war Physalia physalis, Caravela - Small distal spicules - Toxic and an allergic action - Severe pain (like burning) - Systemic repercussion Haddad, 2013
  54. 54. Animals of Medical Interest in Brazil Venomous Invertebrates: Jellyfish Medusa, Água Viva - Small distal spicules - Toxic and an allergic action - Severe pain (like burning) - Systemic repercussion Haddad, 2013
  55. 55. Animals of Medical Interest in Brazil Some Trauma Animals 1. Fish: Moray eels (Muraenidae), Sharks, etc. 2. Invertebrates: Sea Urchin, Crabs, etc. Haddad, 2015Google
  56. 56. Animals of Medical Interest in Brazil Trauma Invertebrates: Sea Urchin Ouriço do Mar - Spine penetration and breaking - Pain and Inflammation - Granuloma and Secondary Infection - Most common injury Haddad, 2013
  57. 57. Animals of Medical Interest in Brazil • 1927-2015: 143 attacks (official data) • Systematic report: only after 1992 • Main concentration in the Northeast Region • Metropolitan area of Recife is the most affected • Main species: Bull, Tiger, Sand Tiger and Great White
  58. 58. Animals of Medical Interest in Brazil • 1927-1992: only 6 attacks in Pernambuco (official data) • Systematic report: only after 1992 • 1992-2015: 60 attacks (until July 2015) • Metropolitan area of Recife is the most affected • Main species: Bull (cabeça chata) and Tiger (tigre) Pernambuco State CEMIT, 2013
  59. 59. Animals of Medical Interest in Brazil • Shark Attacks in beaches - Boa Viagem and Piedade: 69.4% - Urban and crowded beaches CEMIT, 2013 Google
  60. 60. Animals of Medical Interest in Brazil • Deaths between 1992-2015: - 24 deaths from 60 attacks reported - Mortality rate: 40% - Deaths by Exposure Category: Bathers = 83.3% - 2012-2015 (until August): 5 attacks (4 fatal), 4 males, all bathers - Cause of death: massive trauma injuries CEMIT, 2013
  61. 61. Animals of Medical Interest in Brazil • The most recent death, case report: - 07/21/2013, Monday, 1:20 p.m. - Boa Viagem beach, tourists in the water - Two girls were taken by sea current to a deeper area - Lifeguard was called due to drowning risk - Trying to swim, an 18 y/o female was bitten by a shark Globo TV, 2013 OESP, 2013
  62. 62. Animals of Medical Interest in Brazil • The most recent death, case report: - Rescued from the water and taken to the hospital, 2 episodes of CRA - Hypovolemic sock, BP: 0x0, unconscious - Trauma lesion on the left leg - Extensive blood, musculature and bone loss - Amputation of the leg and all supportive therapies were performed - Death after 10 hours of the attack OESP, 2013 Restauração Hospital Archive
  63. 63. Animals of Medical Interest in Brazil • Why are these attacks so frequent? General Reasons - Same habitat: high population densities of sharks and humans - Public warnings are constantly ignored, mainly by tourists - Sea sports and other activities are increasing (e.g. surf) - Splashing of arms and legs can attract sharks - An occasional attack can be considered normal
  64. 64. Animals of Medical Interest in Brazil • Why are these attacks so frequent? Specific Reasons - High frequency of aggressive shark species OESP, 2013
  65. 65. Animals of Medical Interest in Brazil • Why are these attacks so frequent? Specific Reasons - Topography: a deep channel, 100 meters of the shore OESP, 2013
  66. 66. Animals of Medical Interest in Brazil • Why are these attacks so frequent? Specific Reasons 1. Changes in the Suape bay, a natural nursery of aquatic life, in order to build the port (1980) could have dislodged the sharks. 2. Sharks usually follow the ships 3. Waste and blood from a slaughterhouse were thrown into a close river.
  67. 67. Animals of Medical Interest in Brazil 1. The Brazilian Biodiversity 2. Amazon Biome 3. Pantanal Biome 4. Atlantic Forest Biome 5. Marine Biome 6. Conclusions
  68. 68. Animals of Medical Interest in Brazil • In a continental country, huge biodiversity • Many animal can be dangerous to humans • Disturbs to the ecological balance = Accidents • Research and learn with animals biology and behavior • Fight against predatory exploration of the wildlife
  69. 69. Thank you for your attention! SAE de Infectologia HC UNESP Botucatu Faculdade de Medicina UNESP

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